RT Journal
A1 Bragg LE, Thompson JS
T1 COncomitant cholecystectomy for asymptomatic cholelithiasis
JF Archives of Surgery
JO Archives of Surgery
YR 1989
FD April 1
VO 124
IS 4
SP 460
OP 462
DO 10.1001/archsurg.1989.01410040070016
UL http://dx.doi.org/10.1001/archsurg.1989.01410040070016
AB • The outcome of 68 patients with asymptomatic cholelithiasis undergoing laparotomy for other conditions was reviewed to determine those most likely to become symptomatic postoperatively. Thirty-seven patients (54%) became symptomatic postoperatively. Eight patients (22%) required cholecystectomy within 30 days of operation or within the same hospitalization. These patients fasted for a longer period of time postoperatively (15±21 vs 4±3 days) than those undergoing later cholecystectomy. Significantly more of these patients required transfusion (38% vs 7%), mechanical ventilation (50% vs 11%), and total parenteral nutrition (50% vs 18%). Cholelithiasis frequently becomes symptomatic after laparotomy for other intra-abdominal conditions. Patients who require mechanical ventilation, transfusions, and parenteral nutrition and who are slow to resume enteral nutrition are more likely to require early cholecystectomy. Concomitant cholecystectomy adds minimal morbidity to other procedures and should be undertaken unless specific contraindications exist, particularly in this high-risk group.(Arch Surg 1989;124:460-462)